Department of Neurology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Reproductive and Genetics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Brain Behav. 2022 Dec;12(12):e2780. doi: 10.1002/brb3.2780. Epub 2022 Nov 9.
Rapid yet comprehensive neuroimaging protocols are required for patients with suspected acute stroke. However, stroke mimics can account for approximately one in five clinically diagnosed acute ischemic strokes and the rate of thrombolyzed mimics can be as high as 17%. Therefore, to accurately determine the diagnosis and differentiate mimics from true transient ischemic attacks, acute ischemic stroke is a challenge to every clinician.
Medical history and neurological examination, noncontract head computed tomography, and routine magnetic resonance imaging play important roles in the assessment and management of patients with transient neurological attacks in the emergency department. This review attempts to summarize how neuroimaging can be utilized to help differentiate the most common mimics from transient ischemic attack and acute ischemic stroke.
Although imaging can help direct critical triage decisions for intravenous thrombolysis or endovascular therapy, more detailed medical history and neurological examination are crucial for making a prompt and accurate diagnosis for transient neurological attack patients.
疑似急性中风的患者需要快速而全面的神经影像学检查。然而，中风模拟病例约占临床诊断的急性缺血性中风的五分之一，溶栓模拟病例的比例高达 17%。因此，准确确定诊断并区分模拟病例和真正的短暂性脑缺血发作对每位临床医生来说都是一个挑战。
在急诊科，病史和神经系统检查、非对比头部计算机断层扫描和常规磁共振成像在评估和管理短暂性神经发作患者方面发挥着重要作用。本综述试图总结神经影像学如何用于帮助区分最常见的模拟病例与短暂性脑缺血发作和急性缺血性中风。
虽然影像学检查有助于指导静脉溶栓或血管内治疗的关键分诊决策，但对于短暂性神经发作患者，更详细的病史和神经系统检查对于快速准确地诊断至关重要。
